Part-Time Preschool Registration

Part-Time Preschool

Please indicate 1st class choice: REQUIRED 3's Morning Class: 3 days (Tues/Wed/Thurs) 9:00 AM - 11:30 AM - must be 3 by Sept. 30, 2026. $259.00 per month 3's Afternoon Class: 3 days (Tues/Wed/Thurs) 12:30 PM - 3:00 PM - must be 3 by Sept. 30, 2026. $259.00 per month 4's Morning Class: 4 days (Mon/Tues/Wed/Thurs) 9:00 AM - 11:30 AM- must be 4 by Sept. 30, 2026. $310.00 per month 4's Afternoon Class: 4 days (Mon/Tues/Wed/Thurs) 12:30 PM - 3:00 PM- must be 4 by Sept. 30, 2026. $310.00 per month 4.5 & 5 year old Preschool** - 5 days Monday - Friday 9:00 AM to 12:00 PM $400.00 per month **must be 5 by December 1, 2026 Please fill out this field.
Please indicate 2nd class choice: REQUIRED 3's Morning Class: 3 days (Tues/Wed/Thurs) 9:00 AM - 11:30 AM - must be 3 by Sept. 30, 2026. $259.00 per month 3's Afternoon Class: 3 days (Tues/Wed/Thurs) 12:30 PM - 3:00 PM - must be 3 by Sept. 30, 2026. $259.00 per month 4's Morning Class: 4 days (Mon/Tues/Wed/Thurs) 9:00 AM - 11:30 AM- must be 4 by Sept. 30, 2026. $310.00 per month 4's Afternoon Class: 4 days (Mon/Tues/Wed/Thurs) 12:30 PM - 3:00 PM- must be 4 by Sept. 30, 2026. $310.00 per month 4.5 & 5 year old Preschool** - 5 days Monday - Friday 9:00 AM to 12:00 PM $400.00 per month **must be 5 by December 1, 2026 Please fill out this field.

Extended Day Add On

Child Information

First Name REQUIRED Please fill out this field. Please enter valid data.
Middle Name REQUIRED Please fill out this field. Please enter valid data.
Last Name REQUIRED Please fill out this field. Please enter valid data.
Name we should use in school REQUIRED Please fill out this field. Please enter valid data.
Gender REQUIRED Please fill out this field.
Race: American Indian Asian Black Hispanic Pacific Islander White Other
Birthday REQUIRED Please fill out this field. Please enter a date.
Please list food allergies

Parish & Sibling Information

Family's Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.
Parish Currently Attending REQUIRED Please fill out this field. Please enter valid data.
Does this child have siblings at St. Ann Catholic School? REQUIRED Please fill out this field.
Does this child have an interest in attending St. Ann Catholic School (K-8) in the future? REQUIRED Please fill out this field.

Parent/Guardian Information

Language Spoken at Home REQUIRED Please fill out this field. Please enter valid data.
Main Contact Email REQUIRED Please fill out this field. Please enter an email address.
Child lives** with REQUIRED Both parents Parent & Stepparent Mother Only Father Only Other* Please fill out this field.
**Reminder | The Young Child Center (YCC) Office requests a copy of the current custody agreement from those families that have separated and/or divorced parents. Thank you for your cooperation in providing this document in a timely manner to the YCC office.
* If other, please list here Please enter valid data.

Father's Information or Legal Guardian

Mother's Information or Legal Guardian

Best phone number while your child is at school.

Phone Number REQUIRED

Please fill out this field. Please enter a phone number.
Phone Type REQUIRED Please fill out this field.
Name of the person associated with the above number? REQUIRED Please fill out this field. Please enter valid data.

Phone number to be published in classroom roster.

Medical Information

Child's Physician REQUIRED Please fill out this field. Please enter valid data.
Physician's Phone Number REQUIRED

Please fill out this field. Please enter a phone number.
Child's Dentist REQUIRED Please fill out this field. Please enter valid data.
Dentist's Phone Number REQUIRED

Please fill out this field. Please enter a phone number.

Emergency Contact*

* Emergency name and phone number other than parent’s if they cannot be reached.
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED

Please fill out this field. Please enter a phone number.
Relationship to Child REQUIRED Please fill out this field. Please enter valid data.

Pick Up Authorization

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Relationship to Child REQUIRED Please fill out this field. Please enter valid data.

Media Release

I hereby grant permission to St. Ann Young Child Center to use and reproduce photographs taken of my child. These photographs may be used for news and editorial purposes in publications, electronic reproductions (web sites), church & school social media, and/or brochures. In addition, I grant permission to alter the same photos without restriction and to copyright the same. I hereby release the photographer, the journalists, and the publications or media outlets they represent, as well as St. Ann Young Child Center from all claims and liability relating to said photographs.
I Agree (Media Release) REQUIRED Please fill out this field.

HANDBOOK & DISCIPLINE AGREEMENT

Your acknowledgement states that you accept and support the policies and procedures, in addition to the discipline policy, stated within the handbook. The administration reserves the right to interpret and apply the policies and procedures in the handbook and discipline policy. St. Ann Young Child Center reserves the right to amend the handbook and the discipline policy. Notice of any amendments will be sent to families through email, written communication, or Enews.

HANDBOOK

*Password:StAnnYCC25!
I Agree (Handbook) REQUIRED Please fill out this field.

Parent/Guardian Agreement

A $195.00 per child registration fee shall accompany this registration form. The registration fee is non-refundable.

Parent/Guardian shall give the director of St. Ann Young Child Center one month written notice prior to withdrawal of a child. An extra payment of one month’s tuition shall be paid if this notice is not given.
Parent Signature REQUIRED Please fill out this field. Please enter valid data.
I Agree Please select this field.

Registration Fee:195.0

2026-2027 Registration